Critical Non-Covalent Binding Intermediate for an Allosteric Covalent Inhibitor of SUMO E1

Post-translational modifications by small ubiquitin-like modifiers (SUMOs) are dysregulated in many types of cancers. The SUMO E1 enzyme has recently been suggested as a new immuno-oncology target. COH000 was recently identified as a highly specific allosteric covalent inhibitor of SUMO E1. However, a marked discrepancy was found between the X-ray structure of the covalent COH000-bound SUMO E1 complex and the available structure-activity relationship (SAR) data of inhibitor analogues due to unresolved noncovalent protein-ligand interactions. Here, we have investigated noncovalent interactions between COH000 and SUMO E1 during inhibitor dissociation through novel Ligand Gaussian accelerated molecular dynamics (LiGaMD) simulations. Our simulations have identified a critical low-energy non-covalent binding intermediate conformation of COH000 that agreed excellently with published and new SAR data of the COH000 analogues, which were otherwise inconsistent with the X-ray structure. Altogether, our biochemical experiments and LiGaMD simulations have uncovered a critical non-covalent binding intermediate during allosteric inhibition of the SUMO E1 complex.

Outcomes of complex colorectal polyps managed by multi-disciplinary team strategies-a multi-centre observational study

PURPOSE

Team management strategies for complex colorectal polyps are recommended by professional guidelines. Multi-disciplinary meetings are used across the UK with limited information regarding their impact. The aim of this multi-centre observational study was to assess procedures and outcomes of patients managed using these approaches.

METHOD

This was a retrospective, observational study of patients managed by six UK sites. Information was collected regarding procedures and outcomes including length of stay, adverse events, readmissions and cancers.

RESULTS

Two thousand one hundred ninety-two complex polyps in 2109 patients were analysed with increasing referrals annually. Most presented symptomatically and the mean polyp size was 32.1 mm. Primary interventions included endoscopic therapy (75.6%), conservative management (8.3%), colonic resection (8.1%), trans-anal surgery (6.8%) or combined procedures (1.1%). The number of primary colonic resections decreased over the study period without a reciprocal increase in secondary procedures or recurrence. Secondary procedures were required in 7.8%. The median length of stay for endoscopic procedures was 0 days with 77.5% completed as day cases. Median length of stay was 5 days for colonic resections. Overall adverse event and 30-day readmission rates were 9.0% and 3.3% respectively. Malignancy was identified in 8.8%. Benign polyp recurrence occurred in 13.1% with a median follow up of 30.4 months. Screening detected lesions were more likely to undergo bowel resection. Colonic resection was associated with longer stays, higher adverse events and more cancers on final histology.

CONCLUSION

Multi-disciplinary team management of complex polyps is safe and effective. Standardisation of organisation and quality monitoring is needed to continue positive effects on outcomes and services.

First report the role of benthic macroinvertebrates as preys for native fish in Toltén river (38° S, Araucania region Chile)

The Toltén river is located in the 137 years old Araucania region, Chile (38° S), and is characterized by low alterations through human interference due agriculture and towns in its surrounding basin, the presence of native fishes and salmonids, and by its lake effluent regime originated from Villarrica lake. The aim of the present study was to make a review of ecological role of the benthic inland water macroinvertebrates as preys for native fishes of the River Toltén, in order to understand their importance in the ecosystem of the river. The literature revealed that the main prey for native fishes are Chironomidae larvae, nevertheless there are not specific reports for Tolten river. The exposed results are similar with similar native species for Patagonia, and these native species would have prey for introduced salmonids, or these species would have prey competition with introduced salmonids in according to the literature descriptions for Argentinean and Chilean Patagonia.

Optimization of the extraction of phenolic compounds and antioxidant activity from the roots of Waltheria ovata using the response surface methodology

Waltheria ovata is a medicinal plant belonging to the Sterculiaceae genus. Natural products of Waltheria ovata could be used in the food industry as natural antioxidants due to its high content of polyphenols according to the literature. The main objective in this research was to optimize the extraction of phenolic compounds and the antioxidant activity from Waltheria ovata roots using response surface methodology (RSM). The total phenolic content in different extracts was determined by spectrophotometric method (Folin-Ciocalteu reagent) and the antioxidant activity by using DPPH assay. To optimize the conditions for total phenolic content and antioxidant activity were used three independent variables: solvent/sample ratio (1:10, 1:20 and 1:30 g/mL), temperature (40, 50, and 60°C) and time (40, 50 and 60 mins). The results showed that total phenolic content and antioxidant activity in the experiments ranged from 8.7 to 12.1 mg GAE/g and 76.1% to 96.7%, respectively. The coefficients of determination (R2 values) for phenolic content and antioxidant activity were 0.86 and 0.91, respectively. Under the optimum conditions of 1:20 g/mL, 60°C and 55 mins of extraction, the values for total phenolic content and antioxidant activity were 0.448±0.02 mg GAE/g and 87.00±2.0%, respectively. These data showed that the experimental responses were reasonably close to the predicted responses (0.444 mg GAE/g and 84.67%). Therefore, the results showed that Waltheria ovata can be used as antioxidant in foods.

Medial opening wedge high tibial osteotomy: more than ten years of experience with Puddu plate technique supports its indication

PURPOSE

To describe the short-term and long-term results of patients who underwent a medial opening wedge high tibial osteotomy (MOW-HTO) for unicompartmental medial knee joint osteoarthritis.

METHODS

A retrospective review was conducted of patients with MOW-HTO using a Puddu plate®, with more than ten year follow-up. The degree of correction, initial chondral damage, number of meniscal lesions, preoperative and 1-year postoperative functional scale scores (IKDC and Lysholm), and arthroplasty conversion rates at the ten year follow-up were registered. We assumed early indication when patients underwent the operation before they were 40 years old and delayed ≥ 40. Functional outcomes were analyzed by adjusting for pre-operative values. Fisher's exact test was used to study the association between the arthroplasty conversion rates and the timing of indication.

RESULTS

Fifty-five patients were included, 37 of whom were male (67%). Twenty-nine patients had early indications for surgery (53%). All patients completed ten year follow-up. All patients improved IKDC (p < 0.01) and Lysholm (p < 0.01) scores compared to their presurgical scores at the one year post-operative evaluation. We had six minor complications, none requiring revision surgery. We had three conversions to arthroplasty, all in the late indication group, not statistically significant different. Linear regression showed that early indication was associated with a higher IKDC score when adjusting for the Outerbridge chondral damage score, the number of meniscal lesions, and sex (p < 0.01).

CONCLUSION

All patients improved functional scores one year after surgery. Early indication (i.e., younger than 40 years of age) was independently associated with better functional outcomes than late indication at one year follow-up.

Standard culture of Paratanytarsus grimmii Schneider, 1885 (Diptera: Chironomidae), for its use in toxicity bioassays

The management and use of native species under laboratory conditions is the main difficult for species proposal for its use in bioassays. The present study showed the results about management under controlled conditions of Paratanytarsus grimmii (Diptera: Chironomidae), that is a parthenogenetic species with wide geographical distribution. It obtained its eggs from a pre Andean river from Araucania region (39° S), and it determined the conditions for larval rearing under artificial food, adults getting (manipulation), eggs (hatching sincronization) and larvae getting after hatching. The P.grimmii life cycle had larvae that late 23 days in get the pupa stage (stage I to IV), the adult within the next 48 hours deposits the eggs that hatched at 72 hours. It stablished laboratory conditions: incubation room temperature, water pH, and artificial feeding, photoperiod and larvae and eggs management techniques. In according to obtained results it managed all life cycles under laboratory conditions that can propose the use of this species as potential biological material for toxicity bioassays.

Assessing the growth of Arctic charr (Salvelinus alpinus) (Linnaeus, 1758) in four salinities, under experimental conditions

Studies in Salvelinus alpinus, Arctic charr, indicate that it has a low capacity to hyposmorregulatory or adaption to sea in winter periods in Arctic waters. The investigation finds to determinate the rank optimum of salinity to can cultivate this species at Chile. The weight adequate was determined to join on the sea by analysis of gill Na+, K+-ATPase activity, that it was found between the ranks 80-130 g, with 14.5 U/mg. It underwent evaluation of fish growth of 72 g salinities from 0 (control), 18, 25 and 33 g/L (sea water) for 94 days. The results indicate that the largest increases were obtained in brackish water. T18 g/L and T25 g/L achieved growth of 25% and 19% on day 94 and term sampling respectively. It is important to mention that the 8% that survived in seawater introduced percentages growth 16.6% equivalent to brackish water and control. These results suggest that Salvelinus alpinus can grow in seawater, with levels of Na+, K+-ATPase similar to those submitted by Salmo salar with a weight not less than 80 g.

Determination of acute toxicity of ammonium in juvenile Patagonian blenny (Eleginops maclovinus)

Abstract Deionized ammonium (NH3) acute toxicity (LC50-96h) in Patagonian blenny juveniles (Eleginops maclovinus) was assessed. Concentrations of deionized ammonium in salt water were prepared by using 24.09 ± 2.1 g ammonium chloride (NH4Cl). Fish were exposed in triplicates to different ammonium concentrations: 0.05; 0.094; 0.175; 0.325 and 0.605 mg NH3 L-1. Additionally, a control group was included. Experimental fish were kept at a photoperiod of 16:8h. Average temperatures were 16.24 ± 1.40 °C. Oxygen concentration was 7.16 ± 0.40 mg L -1. Water pH was 7.89 ± 0.2. LC50-96 h, was estimated by using Probit statistical method (95% intervals) using EPA software (1993). Juveniles of E. maclovinus showed a LC50-96h of 0.413mg NH3 L-1 value, different from most marine species. This study presents the first record of ammonium toxicity in marine species of Chile.

First report of inventory and role of macroinvertebrates and fish in Cautín river (38° S, Araucania region Chile)

The Cautin river is located in the 137 years old Araucania region, Chile (38°S), and is characterized by alterations through human interference due agriculture and towns in its surrounding basin, the presence of salmonids, and by its mixed regime, originated from snow melting in summer and rains in winter. The aim of the present study was to make a review of the inventory and ecological role of the benthic inland water macroinvertebrates of the River Cautin, in order to understand their importance in the ecosystem of the river. The fauna of this river includes a fauna composed of endemic and introduced fish, which has, however, been only poorly studied until now. The literature revealed the presence of abundant populations of Diptera, Trichoptera and Ephemeroptera larval stages, and few crustaceans specifically amphipods and freshwater crabs along the river's course. Many of these macroinvertebrates are prey for both introduced salmonids and native fishes. Similar results have been reported for other southern Argentinean and Chilean Patagonian rivers.

Allosteric Inhibition of Ubiquitin-like Modifications by a Class of Inhibitor of SUMO-Activating Enzyme

Ubiquitin-like (Ubl) post-translational modifications are potential targets for therapeutics. However, the only known mechanism for inhibiting a Ubl-activating enzyme is through targeting its ATP-binding site. Here we identify an allosteric inhibitory site in the small ubiquitin-like modifier (SUMO)-activating enzyme (E1). This site was unexpected because both it and analogous sites are deeply buried in all previously solved structures of E1s of ubiquitin-like modifiers (Ubl). The inhibitor not only suppresses SUMO E1 activity, but also enhances its degradation in vivo, presumably due to a conformational change induced by the compound. In addition, the lead compound increased the expression of miR-34b and reduced c-Myc levels in lymphoma and colorectal cancer cell lines and a colorectal cancer xenograft mouse model. Identification of this first-in-class inhibitor of SUMO E1 is a major advance in modulating Ubl modifications for therapeutic aims.

Molecular mechanism of a covalent allosteric inhibitor of SUMO E1 activating enzyme

E1 enzymes activate ubiquitin (Ub) and ubiquitin-like modifiers (Ubls) in the first step of Ub/Ubl conjugation cascades and represent potential targets for therapeutic intervention in cancer and other life-threatening diseases. Here, we report the crystal structure of the E1 enzyme for the Ubl SUMO in complex with a recently discovered and highly specific covalent allosteric inhibitor (COH000). The structure reveals that COH000 targets a cryptic pocket distinct from the active site that is completely buried in all previous SUMO E1 structures and that COH000 binding to SUMO E1 is accompanied by a network of structural changes that altogether lock the enzyme in a previously unobserved inactive conformation. These structural changes include disassembly of the active site and a 180° rotation of the catalytic cysteine-containing SCCH domain, relative to conformational snapshots of SUMO E1 poised to catalyze adenylation. Altogether, our study provides a molecular basis for the inhibitory mechanism of COH000 and its SUMO E1 specificity, and also establishes a framework for potential development of molecules targeting E1 enzymes for other Ubls at a cryptic allosteric site.

Rare coding variant analysis in a large cohort of Ashkenazi Jewish families with inflammatory bowel disease

Rare variants are thought to contribute to the genetics of inflammatory bowel disease (IBD), which is more common amongst the Ashkenazi Jewish (AJ) population. A family-based approach using exome sequencing of AJ individuals with IBD was employed with a view to identify novel rare genetic variants for this disease. Exome sequencing was performed on 960 Jewish individuals including 513 from 199 multiplex families with up to eight cases. Rare, damaging variants in loci prioritized by linkage analysis and those shared by multiple affected individuals within the same family were identified. Independent evidence of association of each variant with disease was assessed. A number of candidate variants were identified, including in genes involved in the immune system. The ability to achieve statistical significance in independent case/control replication data was limited by power and was only achieved for variants in the well-established Crohn's disease gene, NOD2. This work demonstrates the challenges of identifying disease-associated rare damaging variants from exome data, even amongst a favorable cohort of familial cases from a genetic isolate. Further research of the prioritized rare candidate variants is required to confirm their association with the disease.

Evaluation of survival and metamorphosis of larvae of Caligus rogercresseyi (Boxshall and Bravo, 2000) (Crustacea, Copepoda) in Chile, depending on temperature, salinity and oxygen

The present study assessed the percentage of survival and metamorphosis of larval stages of Caligus rogercresseyi (Boxshall and Bravo, 2000) nauplius I, nauplius II to and nauplius II to copepodite, conducting bioassays in triplicate with 50 larvae each, nauplius I or nauplius II, at temperature of 12 °C, 15 °C and 18 °C; salinity 20, 23, 25, 2729, 31, 33 and 35 g/L and oxygen saturation with ranges between 30-60%, 90-100% and 190 - 200%. Bioassays were performed in station Quillaipe of Fundación Chile, Puerto Montt, Chile. It is concluded that the temperature is inversely proportional to the time of metamorphosis and survival of the larvae of Caligus rogercresseyi . In salinity is observed that increased this, greater is the percentage of survival and metamorphosis is faster, while the larvae do not survive less than 20g/L. Oxygen saturation ranges indicate that the larvae do not survive at saturations between 30-60%, and it had no differences between 90-100% saturation and 190-200%.

Implementation of a National Priority Allocation System for Hypersensitized Patients in Spain, Based on Virtual Crossmatch: Initial Results

Access to kidney transplantation for patients with high levels of antibodies against HLA is a major challenge. This issue makes it difficult to detect compatible donors for those patients in a certain geographical area. Consequently, hypersensitized patients remain on the waiting list for long periods and their quality of life deteriorates. Our purpose was to increase access to transplantation for highly sensitized patients by developing a national priority allocation system based on virtual crossmatch. Between June 15, 2015, and May 15, 2016, 675 patients on the kidney transplant waiting list with calculated panel-reactive antibodies ≥98% and undergoing dialysis for at least 12 months were included in the study; 86.1% of the patients had previously received at least one transplant. Solid-phase immunoassays were used to identify class I and II HLA antibodies in all patients. Participating hospitals assigned to the program one of the kidneys of every identified brain-dead real donor between 18 and 70 years old. Survival data were collected for the recipients transplanted between June 15, 2015, and December 31, 2015. In all, 475 (290 male and 185 female) brain-dead donors were assigned to the program. Virtual crossmatch was negative for 191 (41%) donors, 149 offers were accepted, and 102 (21.8%) kidneys were transplanted. At the end of the study, patient and graft survival were both 93.4%. The implementation of a national prioritization system based on virtual crossmatch increased access to transplantation for highly sensitized patients, with excellent results in terms of patient and graft survival.

Interventional therapies and in-hospital outcomes in acute coronary syndromes complicated by von Willebrand disease

INTRODUCTION

von Willebrand disease (VWD) is one of the most common inherited bleeding disorders.

AIM

Investigate the impact of the VWD bleeding tendency on in-hospital management of acute coronary syndromes (ACS).

METHODS

Using discharge data from the National Inpatient Sample (NIS), the features of presentation and in-hospital treatment among ACS hospital discharges with and without a VWD diagnosis were investigated. A total of 264 case discharges and 705 860 control discharges were identified.

RESULTS AND CONCLUSIONS

There was a significantly higher percentage of women among the case discharges compared to the control discharges (59.5% and 39.4%, respectively; P < 0.001). The rate of medical therapy alone [i.e. avoidance of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)] was significantly higher among unstable angina cases than controls (55.0% vs. 46.4%; P = 0.01), and among cases undergoing PCI, bare-metal stents (BMS) were utilized in preference to drug-eluting stents (DES) (adjusted OR = 3.5); P < 0.001). No difference in in-hospital death was identified, but reported bleeding among discharges that underwent CABG was higher in cases compared to controls (12.9% vs. 5.2%; P = 0.047). Although medical and interventional management of ACS appears to be well tolerated in the majority of hospitalized patients with VWD, the gender ratio is reversed, interventions and DES are utilized less frequently and procedure-related bleeding may be increased, calling for further study.

Observation of an E2 (Ubc9)-homodimer by crystallography

Post-translational modifications by the small ubiquitin-like modifiers (SUMO), in particular the formation of poly-SUMO-2 and -3 chains, regulates essential cellular functions and its aberration leads to life-threatening diseases (Geoffroy and Hay, 2009) [1]. It was shown previously that the non-covalent interaction between SUMO and the conjugating enzyme (E2) for SUMO, known as Ubc9, is required for poly-SUMO-2/3 chain formation (Knipscheer et al., 2007) [2]. However, the structure of SUMO-Ubc9 non-covalent complex, by itself, could not explain how the poly-SUMO-2/3 chain forms and consequently a Ubc9 homodimer, although never been observed, was proposed for poly-SUMO-2/3 chain formation (Knipscheer et al., 2007) [2]. Here, we solved the crystal structure of a heterotrimer containing a homodimer of Ubc9 and the RWD domain from RWDD3. The asymmetric Ubc9 homodimer is mediated by the N-terminal region of one Ubc9 molecule and a surface near the catalytic Cys of the second Ubc9 molecule (Fig. 1A). This N-terminal surface of Ubc9 that is involved in the homodimer formation also interacts with the RWD domain, the ubiquitin-fold domain of the SUMO activating enzyme (E1), SUMO, and the E3 ligase, RanBP2 (Knipscheer et al., 2007; Tong et al.. 1997; Tatham et al., 2005; Reverter and Lima, 2005; Capili and Lima, 2007; Wang et al., 2009, 2010; Wang and Chen, 2010; Alontaga et al., 2015) [2], [3], [4], [5], [6], [7], [8], [9], [10]. The existence of the Ubc9 homodimer in solution is supported by previously published solution NMR studies of rotational correlation time and chemical shift perturbation (Alontaga et al., 2015; Yuan et al., 1999) [10], [11]. Site-directed mutagenesis and biochemical analysis suggests that this dimeric arrangement of Ubc9 is likely important for poly-SUMO chain formation (Fig. 1B and C). The asymmetric Ubc9 homodimer described for the first time in this work could provide the critical missing link in the poly-SUMO chain formation mechanism. The data presented here are related to the research article entitled, "RWD domain as an E2 (Ubc9) interaction module" (Alontaga et al., 2015) [10]. The data of the crystal structure has been deposited to RCSB protein data bank with identifier: 4Y1L.

A Novel Class of HIV-1 Antiviral Agents Targeting HIV via a SUMOylation-Dependent Mechanism

We have recently identified a chemotype of small ubiquitin-like modifier (SUMO)-specific protease (SENP) inhibitors. Prior to the discovery of their SENP inhibitory activity, these compounds were found to inhibit HIV replication, but with an unknown mechanism. In this study, we investigated the mechanism of how these compounds inhibit HIV-1. We found that they do not affect HIV-1 viral production, but significantly inhibited the infectivity of the virus. Interestingly, virions produced from cells treated with these compounds could gain entry and carry out reverse transcription, but could not efficiently integrate into the host genome. This phenotype is different from the virus produced from cells treated with the class of anti-HIV-1 agents that inhibit HIV protease. Upon removal of the SUMO modification sites in the HIV-1 integrase, the compound no longer alters viral infectivity, indicating that the effect is related to SUMOylation of the HIV integrase. This study identifies a novel mechanism for inhibiting HIV-1 integration and a new class of small molecules that inhibits HIV-1 via such mechanism that may contribute a new strategy for cure of HIV-1 by inhibiting the production of infectious virions upon activation from latency.

Magnetic resonance imaging-quantified small bowel motility is a sensitive marker of response to medical therapy in Crohn's disease

BACKGROUND

Magnetic resonance enterography (MRE) can measure small bowel motility, reduction in which reflects inflammatory burden in Crohn's Disease (CD). However, it is unknown if motility improves with successful treatment.

AIM

To determine if changes in segmental small bowel motility reflect response to anti-TNFα therapy after induction and longer term.

METHODS

A total of 46 patients (median 29 years, 19 females) underwent MRE before anti-TNFα treatment; 35 identified retrospectively underwent repeat MRE after median 55 weeks of treatment and 11 recruited prospectively after median 12 weeks. Therapeutic response was defined by physician global assessment (retrospective group) or a ≥3 point drop in the Harvey-Bradshaw Index (prospective group), C-reactive protein (CRP) and the MaRIA score. Two independent radiologists measured motility using an MRE image-registration algorithm. We compared motility changes in responders and nonresponders using the Mann-Whitney test.

RESULTS

Anti-TNFα responders had significantly greater improvements in motility (median = 73.4% increase from baseline) than nonresponders (median = 25% reduction, P < 0.001). Improved MRI-measured motility was 93.1% sensitive (95%CI: 78.0-98.1%) and 76.5% specific (95% CI: 52.7-90.4%) for anti-TNFα response. Patients with CRP normalisation (<5 mg/L) had significantly greater improvements in motility (median = 73.4% increase) than those with persistently elevated CRP (median = 5.1%, P = 0.035). Individuals with post-treatment MaRIA scores of <11 had greater motility improvements (median = 94.7% increase) than those with post-treatment MaRIA score >11 (median 15.2% increase, P = 0.017).

CONCLUSIONS

Improved MRI-measured small bowel motility accurately detects response to anti-TNFα therapy for Crohn's disease, even as early as 12 weeks. Motility MRI may permit early identification of nonresponse to anti-TNFα agents, allowing personalised treatment.

RWD Domain as an E2 (Ubc9)-Interaction Module

An RWD domain is a well conserved domain found through bioinformatic analysis of the human proteome sequence; however, its function has been unknown. Ubiquitin-like modifications require the catalysis of three enzymes generally known as E1, E2, and E3. We solved the crystal structure of the E2 for the small ubiquitin-like modifiers (SUMO) in complex with an RWD domain and confirmed the structure using solution NMR analysis. The binding surface of RWD on Ubc9 is located near the N terminus of Ubc9 that is known to be involved in noncovalent binding of the proteins in the conjugation machinery, including a domain of E1, SUMO, and an E3 ligase. NMR data indicate that the RWD domain does not bind to SUMO and E1. The interaction between RWD and Ubc9 has a Kd of 32 ± 4 μM. Consistent with the structure and binding affinity and in contrast to a previous report, the RWD domain and RWDD3 have minimal effects on global SUMOylation. The structural and biochemical information presented here forms the basis for further investigation of the functions of RWD-containing proteins.

Design of high-throughput screening assays and identification of a SUMO1-specific small molecule chemotype targeting the SUMO-interacting motif-binding surface

Protein-protein interactions are generally challenging to target by small molecules. To address the challenge, we have used a multidisciplinary approach to identify small-molecule disruptors of protein-protein interactions that are mediated by SUMO (small ubiquitin-like modifier) proteins. SUMO modifications have emerged as a target with importance in treating cancer, neurodegenerative disorders, and viral infections. It has been shown that inhibiting SUMO-mediated protein-protein interactions can sensitize cancer cells to chemotherapy and radiation. We have developed highly sensitive assays using time-resolved fluorescence resonance energy transfer (TR-FRET) and fluorescence polarization (FP) that were used for high-throughput screening (HTS) to identify inhibitors for SUMO-dependent protein-protein interactions. Using these assays, we have identified a nonpeptidomimetic small molecule chemotype that binds to SUMO1 but not SUMO2 or 3. NMR chemical shift perturbation studies have shown that the compounds of this chemotype bind to the SUMO1 surface required for protein-protein interaction, despite the high sequence similarity of SUMO1 and SUMO2 and 3 at this surface.

Active angiogenesis in metastatic renal cell carcinoma predicts clinical benefit to sunitinib-based therapy

Background:

Sunitinib represents a widely used therapy for metastatic renal cell carcinoma patients. Even so, there is a group of patients who show toxicity without clinical benefit. In this work, we have analysed pivotal molecular targets involved in angiogenesis (vascular endothelial growth factor (VEGF)-A, VEGF receptor 2 (KDR), phosphorylated (p)KDR and microvascular density (MVD)) to test their potential value as predictive biomarkers of clinical benefit in sunitinib-treated renal cell carcinoma patients.

Methods:

Vascular endothelial growth factor-A, KDR and pKDR-Y1775 expression as well as CD31, for MVD visualisation, were determined by immunohistochemistry in 48 renal cell carcinoma patients, including 23 metastatic cases treated with sunitinib. Threshold was defined for each biomarker, and univariate and multivariate analyses for progression-free survival (PFS) and overall survival (OS) were carried out.

Results:

The HistoScore mean value obtained for VEGF-A was 121.6 (range, 10–300); for KDR 258.5 (range, 150–300); for pKDR-Y1775 10.8 (range, 0–65) and the mean value of CD31-positive structures for MVD visualisation was 49 (range, 10–126). Statistical differences for PFS (P=0.01) and OS (P=0.007) were observed for pKDR-Y1775 in sunitinib-treated patients. Importantly, pKDR-Y1775 expression remained significant after multivariate Cox analysis for PFS (P=0.01; HR: 5.35, 95% CI, 1.49–19.13) and for OS (P=0.02; HR: 5.13, 95% CI, 1.25–21.05).

Conclusions:

Our results suggest that the expression of phosphorylated (i.e., activated) KDR in tumour stroma might be used as predictive biomarker for the clinical outcome in renal cell carcinoma first-line sunitinib-treated patients.

Upregulation of voltage-gated Ca2+ channels in mouse astrocytes infected with Theiler's murine encephalomyelitis virus (TMEV)

Theiler's murine encephalomyelitis virus (TMEV) induces demyelination in susceptible strains of mice through a CD4(+) Th1 T cell-mediated immunopathological process. TMEV infection produces a syndrome in mice that resembles multiple sclerosis. In this work, we focused on the increased expression of the genes encoding voltage-gated Ca(2+) channel subunits in SJL/J mouse astrocytes infected in culture with a BeAn strain of TMEV. Affymetrix DNA murine genome U74v2 DNA microarray hybridized with cRNA from mock- and TMEV-infected astrocytes revealed the upregulation of four sequences encoding Ca(2+)-binding and Ca(2+) channel subunit proteins. The DNA hybridization results were further validated using conventional RT-PCR and quantitative RT-PCR, demonstrating the increased expression of mRNA encoding channel subunit proteins. Western blotting also showed the increased synthesis of L- and N-type channel subunit specific proteins after infection. The reduced expression and the functional upregulation of functional voltage-gated Ca(2+) channels in mock- and TMEV-infected cells, respectively, was demonstrated using voltage clamp experiments. TMEV infection in mouse astrocytes induced a Ca(2+) current with a density proportional to the amount of viral particles used for infection. The use of Ca(2+) channel blockers, nimodipine and ω-conotoxin-GVIA, showed that both functional L- and N-type Ca(2+) channels were upregulated in infected astrocytes. The upregulation of Ca(2+) channels in astrocytes after TMEV infection provides insight into the molecular processes and potential role of astrocyte Ca(2+) dysregulation in the pathophysiology of encephalomyelitis and is important for the development of novel therapeutic strategies leading to prevention of neurodegeneration.

Identity, expression and functional role of the sodium-activated potassium current in vestibular ganglion afferent neurons

Vestibular afferent neurons (VANs) transmit information from the vestibular end organs to the central nuclei. This information is encoded within the firing pattern of these cells and is heavily influenced by the K⁺ conductances expressed by vestibular neurons. In the present study, we describe the presence of a previously unidentified Na⁺-activated K⁺ conductance (KNa) in these cells. We observed that the blocking of Na⁺ channels by tetrodotoxin (TTX) or the substitution of choline for Na⁺ in the extracellular solution during voltage clamp pulses resulted in the reduction of a sustained outward current that was dependent on the Na⁺ current. Furthermore, increases in the intracellular concentration of Na⁺ that were made by blocking the Na⁺/K⁺ ATPase with ouabain increased the amplitude of the outward current, and reduction of the intracellular Cl⁻ concentration reduced the TTX-sensitive outward current. The substitution of Li⁺ for Na⁺ in the extracellular solution significantly reduced the amplitude of the outward current in voltage clamp pulses and decreased the afterhyperpolarization (AHP) of the action potentials in current clamp experiments. These electrophysiological results are consistent with the presence of mRNA transcripts for the KNa subunits Slick and Slack in the vestibular ganglia and in the sensory epithelium, which were detected using reverse-transcription polymerase chain reaction (RT-PCR). These results are also consistent with the immunolabeling of Slick and Slack protein in isolated vestibular neurons, in the vestibular ganglion and in the vestibular sensory epithelium. These results indicate that KNa channels are expressed in VANs and in their terminals. Furthermore, these data indicate that these channels may contribute to the firing pattern of vestibular neurons.

Incidence of humoral sensitization in HLA partially mismatched hematopoietic stem cell transplantation

As part of the 15th International Histocompatibility and Immunogenetics Workshop (IHIWS), seven centers participated in a collaborative project to determine whether any significant humoral sensitization occurred post-transplant among recipients of HLA partially mismatched hematopoietic cell transplants (HCTs). A total of 140 donor/recipient pairs were enrolled with a total of 367 pre-and post-transplant sera analyzed. The majority of the samples (69.1%) were obtained within 30-90 days post-HCT. HLA-specific antibodies were defined using single antigen bead assays on a Luminex platform with a positive cutoff value of 1000 normalized median fluorescence intensity (MFI). There was an overall incidence of post-HCT sensitization toward donor HLA mismatches of 5.7%; however, all cases were among recipients of one HLA haplotype-mismatched grafts under nonmyeloablative, pre-transplant conditioning. Among the one haplotype-mismatched recipients, 15.7% (8/51) developed donor HLA-specific antibodies and 29.4% also had antibodies directed toward third party HLA antigens. Among the donor-specific antibodies, 9.8% were directed toward HLA class I antigens; 7.8% were against class II antigens; and 2.0% had both class I and II specificity. The relative strength of post-transplant antibodies was low with no significant difference in the mean maximum MFI values between third party and donor-specific antibodies. Because only a small number (10.2%) of the post-transplant samples were obtained 180 days or more post-HCT, longer term study is needed to evaluate any clinical relevance of these low-to-moderate levels of donor-specific antibody in one haplotype-mismatched recipients, as well as to determine whether any other antibodies occur at later times.

Identification of T-cell stimulating antigens from Giardia lamblia by using Giardia-specific T-cell hybridomas

T-cell immune response plays an important role in controlling Giardia lamblia infections. Little is known about the G. lamblia-specific antigens that stimulate a cell-mediated immune response. The aim of the present study was to identify T-cell stimulating G. lamblia antigens. For this purpose, we generated a group of Giardia-specific T-cell hybridomas (2F9, 4D5, 6D10, 8B9, 9B10, 10F7 and 10G5). Hybridomas were screened for reactivity with G. lamblia protein extract by the CTLL bioassay. These T-cell hybridomas did not exhibit any significant activation either in the absence of G. lamblia protein extract or in the presence of irrelevant antigen (hen white egg lysozyme). To further characterize the T-cell hybridomas generated, we selected three hybridomas (10G5, 4D5 and 9B10). Giardia lamblia proteins of 90-110, 65-77 and 40-64 kDa showed T-cell stimulating activity for the hybridomas 10G5, 4D5 and 9B10, respectively, in a concentration-dependent manner. Protein extract obtained from different G. lamblia strains (GS/M-83-H7, WB C6 and a clinical isolate (YJJ)) stimulated all T-cell hybridomas, indicating that T-cell-stimulating antigens are expressed among different G. lamblia strains. In conclusion, we identified T-cell stimulating G. lamblia antigens by using Giardia-specific T-cell hybridomas. To our knowledge, these hybridomas are the first-described T-cell hybridomas specific for G. lamblia.

[Pyoderma gangrenosum peristomal in ulcerative colitis; first report of a case in Mexico]

Pyoderma gangrenosum is one of the most severe extraintestinal manifestations in patients with ulcerative colitis (UC) and Crohn s disease. This lesion is frequently located on the lower extremities and the torso. Peristomal pyoderma gangrenosum (PPG) is extremely rare. We report the first published patient with PPG and UC in Mexico. PPG occurred six weeks after restorative proctocolectomy. Diagnosis was performed by clinical presentation and biopsy. Ulcer resolution was achieved with oral steroids and local wound care. Patient did not show any recurrence at one year follow-up. We suggest suspecting this illness in all patients with UC who had a restorative proctocolectomy and present difficult management peristomal ulcers.

CD20-positive infiltrates in renal allograft biopsies with acute cellular rejection are not associated with worse graft survival

We examined rejection outcome and graft survival in 58 adult patients with acute cellular rejection Banff type I (ARI) or II (ARII), within 1 year after transplantation, with or without CD20-positive infiltrates. Antibody-mediated rejection was not examined. Of the 74 allograft biopsies, performed from 1999 to 2001, 40 biopsies showed ARI and 34 biopsies showed ARII; 30% of all the biopsies showed CD20-positive clusters with more than 100 cells, 9% with more than 200 cells and 5% with more than 275 cells. Patients with B cell-rich (>100 or >200/HPF CD20-positive cells) and B cell-poor biopsies (<50 CD20-positive cells/HPF) were compared. Serum creatinine and eGFR of B cell-rich (CD20 > 100/HPF) and B cell-poor were not significantly different at rejection, or at 1, 3, 6 and 12 months, and during additional 3 years follow-up after rejection, although higher creatinine at 1 year was noted in the >200/HPF group. Graft survival was also not different between B cell-rich and B cell-poor groups (p = 0.8 for >100/HPF, p = 0.9 for >200/HPF CD20-positive cells). Our data do not support association of B cell-rich infiltrates in allograft biopsies and worse outcome in acute rejection type I or II, but do not exclude the possible contribution of B cells to allograft rejection.

Reversible, high-voltage square-wave pulse generator for triggering spark gaps

A design is presented for a reversible, square-pulse generator that employs coaxial cables for charge storage and pulse formation and a thyratron as the switch. The generator has a nominal output voltage of 5-30 kV and a pulse duration determined by the cable's physical length. Two variations are presented: (1) a single-stage one consisting of cable that is charged via its shield on one end and discharged with a thyratron on the opposite end and (2) a two-stage one having an inverting circuit that uses a coaxial cable to reverse the polarity of the pulse. The generator operates with "flying shields," i.e., high-voltage pulses also propagate on the outside of the cables; this calls for a dedicated insulation that avoids breakdown between sections of the cable's shield. The rise time obtained is mostly dictated by the switching time of the thyratron; with the one we used in the tests, rise times in the range of 30-40 ns were obtained. We present the results obtained in the implementation of the generators as well as its application to fire a large Marx generator.

Survival and dependence on home parenteral nutrition: experience over a 25-year period in a UK referral centre

BACKGROUND

Home parenteral nutrition (HPN) is the standard treatment for severe intestinal failure in the United Kingdom.

AIM

To review long-term survival and ongoing HPN dependence of patients receiving HPN treated at a specialist UK referral centre.

METHODS

Medical records of patients commenced on HPN between 1979 and 2003 were reviewed retrospectively. Regression analysis was employed to identify factors associated with poor prognosis.

RESULTS

Case notes of 188 patients were reviewed. Overall probability of survival was 86%, 77%, 73% and 71% at 1, 3, 5 and 10 years after starting treatment. In multivariate analysis, association was seen between mechanism of intestinal failure and survival: short bowel syndrome associated with a favourable prognosis, and intestinal dysfunction, dysmotility and obstruction with poorer prognoses. There was an association between increasing age and poor prognosis, but increased mortality was also seen in the youngest age groups. Only 9% of deaths were due to complications of HPN. Continued HPN dependence was 89%, 87%, 84% and 84% at 1, 3, 5 and 10 years in survivors.

CONCLUSIONS

Long-term survival of patients receiving HPN remains better than that reported after intestinal transplantation. Mortality predominantly relates to underlying disease rather than complications of HPN.

In vitro quantitative determination of ophthalmic irritancy by the chorioallantoic membrane test with trypan blue staining as alternative to eye irritation test

The damage provoked by some substances on the chicken egg's chorioallantoic membrane (CAM) is used as an alternative assay to determine ocular irritation. There is good prediction of the eye irritation when compared to the in vivo Draize method. Nevertheless, this assay has some limitations, such as subjectivity. Hagino et al. developed an objective evaluation technique using the amount of trypan blue absorbed at the site of treatment as an indicator of injury to the CAM. The present work was aimed at the determination of ocular irritation of 21 substances (chemicals and cosmetics). We used the spectrophotometric quantification by trypan blue staining of the damage produced on CAM, of fertile chicken eggs. Results were compared with the values obtained by the traditional Draize assay. We observed a good correlation (r=0.835; p<0.0001) between the amount of dye absorbed by the CAM and the Draize eye irritation test score. The r values were 0.688; p<0.05 for cosmetics and 0.925; p<0.0001 for chemicals. Three chemicals turned as false positive and one cosmetic substance as false negative. The CAM-TBS assay is inexpensive, simple and provides an in vitro alternative method to predict the damage that chemical substances or cosmetics can cause to the ocular structures.

[Ion channels that are sensitive to the extracellular concentration of protons: their structure, function, pharmacology and pathophysiology]

AIM

Acid sensing ion channels (ASIC) members of the ENaC degenerine channel family, have been shown to participate in various sensorial pathways including nociception, also they have been shown to participate in synaptic transmission, learning and memory processes and in the physiopathology of the ischemic stroke.

DEVELOPMENT

The proton concentration in the organism is strictly regulated by distinct buffer systems. Drastic changes of pH are generated only by pathological conditions as is the ischemia; however, some physiological processes may produce local changes in the extracellular pH. Recently, a new family of proton receptors known as ASIC has been cloned. These are ionic channels inactivated at physiological pH (7.4) and activated with a pH fall (increase in H+ concentration). ASICs are permeable to sodium ions and in a lesser degree to calcium ions, activation of these channels leads to an increase in cell excitability. The ASICs are distributed widely in the central and peripheral nervous system, and in specialized epithelia. In the past few years they have become a focus of interest due to its role in nociception, taste perception, long term potentation and the physiopathology of ischemic stroke.

CONCLUSIONS

In this review we address the most relevant molecular, physiological and pharmacological aspects of the ASICs, its participation in some pathological process, and the perspectives of basic and clinic investigation in this arising research field.

Comparative study of red blood cell method in rat and calves blood as alternatives of Draize eye irritation test

INTRODUCTION

Red blood cell assay (RBC) is used to estimate potential irritation of tensioactive agents and detergents. Cell membrane lysis and cell protein denaturation are measured photometrically. This study was aimed to determine if rat blood cells can be used to predict eye potential irritation in the same way of calves blood cells in RBC assay.

METHODS

We evaluated 20 cosmetic formulations using rat and calves blood according to INVITOX protocol No 37. Data of media hemolysis concentration, denaturation index and the ratio of both parameters were compared with in vivo data of eye irritancy.

RESULTS

There was a significant difference (p<0.01) between H50 value when evaluated the standard SDS with red blood cell method in rat and calves blood. According to the exact probability of Fisher taking as approach the acceptance or rejection of the substance there are no significant differences between in vitro assay with calves blood and in vivo results. Not happening the same way for the RBC assay with rat blood where significant differences were obtained (p<0.01) among the classification of in vitro and in vivo test.

DISCUSSION

The RBC assay using calves blood showed better results. Several test substances were false negatives with rat blood. This high false negative rate would be correctly identified by the animal test but it may also lead to increased animal consumption. For that RBC assay with calf blood cells is preferable to the employment of rat blood as screening method with a reduction and refinement strategy.